Clomipramine and Dupilumab Injection: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clomipramine
Dupilumab Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what this means for you. Clomipramine (Anafranil) is broken down in your body partly by a liver enzyme called CYP2D6. Certain medicines can slow that enzyme down, which could let clomipramine build up to higher levels than usual. Higher levels can mean more side effects, like drowsiness, dry mouth, constipation, a fast heartbeat, or dizziness.
The good news is that this concern is theoretical, meaning it's based on how the drugs might interact rather than strong real-world evidence. Your care team can manage it easily by watching how you feel and adjusting your clomipramine dose if needed. Keep taking both as prescribed, and let your pharmacist or doctor know if you notice new or stronger side effects.
Effect: Potential increased clomipramine exposure via inhibition of CYP2D6-mediated metabolism.
- Direction: Clomipramine (a CYP2D6 substrate) may accumulate, raising the risk of anticholinergic effects, sedation, seizures, and QT/conduction effects.
- Evidence: Theoretical; dupilumab's inhibitory potential is not well established, and biologic-CYP interactions are generally modest and driven by inflammatory cytokine modulation.
- Onset: Unspecified.
- Management: Monitor for TCA toxicity and consider plasma clomipramine level monitoring. Dose may need individualization; anticipate needing a dose increase if the interacting agent is discontinued.
What happens
Increased clomiPRAMINE exposure
Interaction Deep Dive
Taking clomiPRAMINE together with CYP2D6 inhibitors can raise clomiPRAMINE exposure and may call for doses below those typically prescribed for either clomiPRAMINE or the co-administered agent. In addition, if one of these medications is discontinued from combined therapy, a higher clomiPRAMINE dose may become necessary. Monitoring clomiPRAMINE exposure is advisable whenever it is given alongside another agent recognized as a CYP2D6 inhibitor1.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated metabolism of clomiPRAMINE
How to manage this interaction
What your care team may do:
- Monitor you more closely for signs of too much clomipramine (drowsiness, dry mouth, constipation, rapid heartbeat, dizziness).
- Check clomipramine blood levels when it is used with a CYP2D6 inhibitor.
- Individualize your clomipramine dose. It may be lowered while on both drugs, and possibly raised again if the other drug is stopped.
What you should do: Keep taking both medications exactly as prescribed. Do not change or stop anything on your own. Tell your pharmacist or prescriber about any new or stronger side effects, and confirm they know you take both medicines.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clomipramine and Dupilumab Injection together?
Combining clomipramine with a CYP2D6 inhibitor could raise clomipramine levels and side effects, though this concern is theoretical. Keep taking both as prescribed and ask your care team to monitor you and adjust the dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clomipramine and Dupilumab Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Clomipramine and Dupilumab Injection interaction managed?
What your care team may do: Monitor you more closely for signs of too much clomipramine (drowsiness, dry mouth, constipation, rapid heartbeat, dizziness). Check clomipramine blood levels when it is used with a CYP2D6 inhibitor. Individualize your clomipramine dose. It may be lowered while on both drugs, and possibly raised again if the other drug is stopped. What you should do: Keep taking both me… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Clomipramine or Dupilumab Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: ANAFRANIL(TM) oral capsules, clomipramine hydrochloride oral capsules. SpecGx LLC (per Dailymed), Webster Groves, MO, 2024. DailyMed
Keep reading about Clomipramine
Keep reading about Dupilumab Injection
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major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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